Trends in the use of cigarettes, cigars, and marijuana among students with and without asthma, 2003-2017

Aim: Asthma has symptoms that can be exacerbated by using combustible products such as tobacco and marijuana. This study assessed the prevalence and trends in current use of cigarettes, cigars, and marijuana among U.S. high school students with and without asthma. Methods: The national Youth Risk Behavior Survey (YRBS) is a biennial, school-based, nationally representative survey of U.S. students in grades 9-12. Trends during 2003-2017 in current (past 30-day) use of cigarettes, cigars, and marijuana among students with and without asthma were examined using logistic regression. Asthma was defined as reporting that a doctor or nurse ever told the student they had asthma. T-tests were used to compare cigarette, cigar, and marijuana use by asthma status and year, frequency of use, and student characteristics. Results: During 2003-2017, both current cigarette and cigar smoking decreased (p < 0.05) with rates that were similar among students with and without asthma. There was no significant linear change in current marijuana use, irrespective of asthma status. During most years, cigarette, cigar, and marijuana use were more common among students with asthma than without. In 2017, the most frequent use of cigarettes, cigars, and marijuana was among those with asthma than without. Differences in cigarette, cigar, and marijuana use by asthma status were apparent by demographic subgroups. Conclusions: Given the adverse respiratory effects of tobacco and marijuana smoking, efforts to educate all youth about the dangers of using these substances is critical, particularly among those with asthma.